Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review

Hailay Abrha Gesesew; Digsu Negese Koye; Dagnachew Muluye Fetene; Mulu Woldegiorgis; Yohannes Kinfu; Ayele Bali Geleto; Yohannes Adama Melaku; Hassen Mohammed; Kefyalew Addis Alene; Mamaru Ayenew Awoke; Mulugeta Molla Birhanu; Amanuel Tesfay Gebremedhin; Yalemzewod Assefa Gelaw; Desalegn Markos Shifti; Muluken Dessalegn Muluneh; Teketo Kassaw Tegegne; Solomon Abrha; Atsede Fantahun Aregay; Mohammed Biset Ayalew; Abadi Kahsu Gebre; Kidane Tadesse Gebremariam; Tesfaye Gebremedhin; Lemlem Gebremichael; Cheru Tesema Leshargie; Getiye Dejenu Kibret; Maereg Wagnew Meazaw; Alemayehu Berhane Mekonnen; Dejen Yemane Tekle; Azeb Gebresilassie Tesema; Fisaha Haile Tesfay; Wubshet Tesfaye; Befikadu Legesse Wubishet; Berihun Assefa Dachew; Akilew Awoke Adane

doi:10.1136/bmjopen-2020-044618

Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review

Hailay Abrha Gesesew
, Digsu Negese Koye
, Dagnachew Muluye Fetene
, Mulu Woldegiorgis
, Yohannes Kinfu
, Ayele Bali Geleto
, Yohannes Adama Melaku
, Hassen Mohammed
, Kefyalew Addis Alene
, Mamaru Ayenew Awoke
, Mulugeta Molla Birhanu
, Amanuel Tesfay Gebremedhin
, Yalemzewod Assefa Gelaw
, Desalegn Markos Shifti
, Muluken Dessalegn Muluneh
, Teketo Kassaw Tegegne
, Solomon Abrha
, Atsede Fantahun Aregay
, Mohammed Biset Ayalew
, Abadi Kahsu Gebre

Kidane Tadesse Gebremariam, Tesfaye Gebremedhin, Lemlem Gebremichael, Cheru Tesema Leshargie, Getiye Dejenu Kibret, Maereg Wagnew Meazaw, Alemayehu Berhane Mekonnen, Dejen Yemane Tekle, Azeb Gebresilassie Tesema, Fisaha Haile Tesfay, Wubshet Tesfaye, Befikadu Legesse Wubishet, Berihun Assefa Dachew, Akilew Awoke Adane

Western Sydney University

Research output: Contribution to journal › Article › peer-review

54 Citations (Scopus)

Abstract

Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

Original language	English
Article number	e044618
Number of pages	10
Journal	BMJ Open
Volume	11
Issue number	2
DOIs	https://doi.org/10.1136/bmjopen-2020-044618
Publication status	Published - 18 Feb 2021

Bibliographical note

Publisher Copyright:
© BMJ Publishing Group Limited 2020.

Open Access - Access Right Statement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 5 Gender Equality
SDG 10 Reduced Inequalities
SDG 11 Sustainable Cities and Communities
SDG 12 Responsible Consumption and Production
SDG 17 Partnerships for the Goals

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10.1136/bmjopen-2020-044618

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Gesesew, H. A., Koye, D. N., Fetene, D. M., Woldegiorgis, M., Kinfu, Y., Geleto, A. B., Melaku, Y. A., Mohammed, H., Alene, K. A., Awoke, M. A., Birhanu, M. M., Gebremedhin, A. T., Gelaw, Y. A., Shifti, D. M., Muluneh, M. D., Tegegne, T. K., Abrha, S., Aregay, A. F., Ayalew, M. B., ... Adane, A. A. (2021). Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review. BMJ Open, 11(2), Article e044618. https://doi.org/10.1136/bmjopen-2020-044618

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title = "Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review",

abstract = "Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.",

author = "Gesesew, \{Hailay Abrha\} and Koye, \{Digsu Negese\} and Fetene, \{Dagnachew Muluye\} and Mulu Woldegiorgis and Yohannes Kinfu and Geleto, \{Ayele Bali\} and Melaku, \{Yohannes Adama\} and Hassen Mohammed and Alene, \{Kefyalew Addis\} and Awoke, \{Mamaru Ayenew\} and Birhanu, \{Mulugeta Molla\} and Gebremedhin, \{Amanuel Tesfay\} and Gelaw, \{Yalemzewod Assefa\} and Shifti, \{Desalegn Markos\} and Muluneh, \{Muluken Dessalegn\} and Tegegne, \{Teketo Kassaw\} and Solomon Abrha and Aregay, \{Atsede Fantahun\} and Ayalew, \{Mohammed Biset\} and Gebre, \{Abadi Kahsu\} and Gebremariam, \{Kidane Tadesse\} and Tesfaye Gebremedhin and Lemlem Gebremichael and Leshargie, \{Cheru Tesema\} and Kibret, \{Getiye Dejenu\} and Meazaw, \{Maereg Wagnew\} and Mekonnen, \{Alemayehu Berhane\} and Tekle, \{Dejen Yemane\} and Tesema, \{Azeb Gebresilassie\} and Tesfay, \{Fisaha Haile\} and Wubshet Tesfaye and Wubishet, \{Befikadu Legesse\} and Dachew, \{Berihun Assefa\} and Adane, \{Akilew Awoke\}",

note = "Publisher Copyright: {\textcopyright} BMJ Publishing Group Limited 2020.",

year = "2021",

month = feb,

day = "18",

doi = "10.1136/bmjopen-2020-044618",

language = "English",

volume = "11",

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issn = "2044-6055",

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Gesesew, HA, Koye, DN, Fetene, DM, Woldegiorgis, M, Kinfu, Y, Geleto, AB, Melaku, YA, Mohammed, H, Alene, KA, Awoke, MA, Birhanu, MM, Gebremedhin, AT, Gelaw, YA, Shifti, DM, Muluneh, MD, Tegegne, TK, Abrha, S, Aregay, AF, Ayalew, MB, Gebre, AK, Gebremariam, KT, Gebremedhin, T, Gebremichael, L, Leshargie, CT, Kibret, GD, Meazaw, MW, Mekonnen, AB, Tekle, DY, Tesema, AG, Tesfay, FH, Tesfaye, W, Wubishet, BL, Dachew, BA & Adane, AA 2021, 'Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review', BMJ Open, vol. 11, no. 2, e044618. https://doi.org/10.1136/bmjopen-2020-044618

TY - JOUR

T1 - Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review

AU - Gesesew, Hailay Abrha

AU - Koye, Digsu Negese

AU - Fetene, Dagnachew Muluye

AU - Woldegiorgis, Mulu

AU - Kinfu, Yohannes

AU - Geleto, Ayele Bali

AU - Melaku, Yohannes Adama

AU - Mohammed, Hassen

AU - Alene, Kefyalew Addis

AU - Awoke, Mamaru Ayenew

AU - Birhanu, Mulugeta Molla

AU - Gebremedhin, Amanuel Tesfay

AU - Gelaw, Yalemzewod Assefa

AU - Shifti, Desalegn Markos

AU - Muluneh, Muluken Dessalegn

AU - Tegegne, Teketo Kassaw

AU - Abrha, Solomon

AU - Aregay, Atsede Fantahun

AU - Ayalew, Mohammed Biset

AU - Gebre, Abadi Kahsu

AU - Gebremariam, Kidane Tadesse

AU - Gebremedhin, Tesfaye

AU - Gebremichael, Lemlem

AU - Leshargie, Cheru Tesema

AU - Kibret, Getiye Dejenu

AU - Meazaw, Maereg Wagnew

AU - Mekonnen, Alemayehu Berhane

AU - Tekle, Dejen Yemane

AU - Tesema, Azeb Gebresilassie

AU - Tesfay, Fisaha Haile

AU - Tesfaye, Wubshet

AU - Wubishet, Befikadu Legesse

AU - Dachew, Berihun Assefa

AU - Adane, Akilew Awoke

PY - 2021/2/18

Y1 - 2021/2/18

N2 - Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

AB - Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. Data sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. Eligibility criteria: Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. Data extraction and synthesis: We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. Results: Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. Conclusions: Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.

UR - https://hdl.handle.net/1959.7/uws:59959

U2 - 10.1136/bmjopen-2020-044618

DO - 10.1136/bmjopen-2020-044618

M3 - Article

SN - 2044-6055

VL - 11

JO - BMJ Open

JF - BMJ Open

IS - 2

M1 - e044618

ER -

Risk factors for COVID-19 infection, disease severity and related deaths in Africa : a systematic review

Abstract

Bibliographical note

Open Access - Access Right Statement

UN SDGs

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